Provider Demographics
NPI:1952515561
Name:SEIDEN, LOUIS
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:
Last Name:SEIDEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 ROUTE 130 N
Mailing Address - Street 2:MAINLINE PROFESSIONAL BUILDING SUITE D
Mailing Address - City:CINNAMINSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08077-3032
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1104 US ROUTE 130 N
Practice Address - Street 2:MAINLINE PROFESSIONAL BUILDING SUITE D
Practice Address - City:CINNAMINSON
Practice Address - State:NJ
Practice Address - Zip Code:08077
Practice Address - Country:US
Practice Address - Phone:856-829-8070
Practice Address - Fax:856-829-8505
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ9641,25521223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics